Individual provider Active NPI

Jerry D Simms, DPM

  • Podiatrist
  • Bensalem, PA
National Provider Identifier
1235116385
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC001724L Issued in PA
Practice address
2404 Bristol Rd
Bensalem, PA 19020-6002
Phone
(215) 752-1881
Fax
(215) 752-6907
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC001724L PA Primary

Addresses

Primary practice location

2404 Bristol Rd
Bensalem, PA 19020-6002

Mailing address

2404 Bristol Rd
Bensalem, PA 19020-6002
Phone (215) 752-1881

Other identifiers 1

IdentifierTypeStateIssuer
1403260MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jcbdpm P.L.L.C. Past Accepting new patients
Dean M Ruday DPM Podiatrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1235116385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 BRISTOL RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190206002",
            "telephone_number": "215-752-1881",
            "fax_number": "215-752-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 BRISTOL RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190206002",
            "telephone_number": "215-752-1881",
            "fax_number": "215-752-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "JERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001724L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1403260",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensalem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.